Objective Reports from the United States that urinary tract infections (UTI) are more common in homosexual than in heterosexual men have not been confirmed in Europe. The occurrence of several UTI in men infected with HIV-1 has been recorded in The Netherlands. We therefore analysed the relationship between the presence of bacteriuria and the immune status (CD4+ cell count) in these HIV-1-infected patients. Design Urinary cultures were obtained prospectively for 2 years, during the first visit and every 6 months thereafter, when signs and symptoms of UTI occurred and when patients had fever of unknown origin. CD4+ cell counts were measured at the same time. Setting The study was performed at the University Hospital, Utrecht, The Netherlands. Patients, participants One hundred and thirty HIV-1-infected men attended our hospital. Data from 98 were analysed. Eighty-nine (91%) of these men were either homo-or bisexual. Main outcome measures Positive urinary culture. Results Group 1 (CD4+ cell count 500 × 106/l). The rate of bacteriuria per patient-month, 4 (group 1) versus 2 (group 2), differed significantly (P < 0.001). A significant relationship between CD4+ cell count and bacteriuria was found (P = 0.00003); no relationship, however, was found with anal intercourse, hospitalization, Karnofsky score, follow-up, or age. Conclusion We conclude that men infected with HIV and presenting with a CD4 + cell count 6/l are at increased risk for bacteriuria.